中国学校卫生

Impact of novel environmental behavior risk factors on adolescent health deserves more attention

TAO Fangbiao

2024, 45(4): 457-460. doi: 10.16835/j.cnki.1000-9817.2024118

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The adolescent health has posed a public health concern around the world. The dramatic change in urbanization, socialeconamic transitions, and multiculture impact often play a driving role in the emergence of new environmental behavioral risk factors, such as exposure to light at night, smartphone multitasking, dietary rhythm disorders, and social jetlag. The dimensions of physical and mental health problems in adolescents were extensive, often based on the most prominent mental health problems, cardiometabolic health, neck-shoulder and low back pain, and clustering of health risk behaviors. In order to achieve the sustainable development goals of promoting adolescent health, it is necessary to strengthen the intervention on novel environmental and behavioral risk factors to prevent the physical and mental health hazards of adolescents from the source.

Experiences and implications of promoting healthy eating in school-aged children by World Health Organization

LI Xiaopeng, XU Chengli, TIAN Jing, XU Changchun

2024, 45(4): 461-464. doi: 10.16835/j.cnki.1000-9817.2024099

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In order to promote the high-quality development of school meals, the article systematically analyzes the Policy Report on Promoting Healthy Meals in Schools issued by World Health Organization (WHO), introduces ways of changing the physical environment of meals and adjusting the provision of dietary information, clarifies the five steps of basic research-goals setting-action plans-implementation-impact evaluation, and points out that the development of school meals in China is facing the realistic difficulties such as unreasonable school nutrition structure, unbalanced nutrition supply, low nutritional awareness of students and serious double malnutrition burden. The paper puts forward the enlightenment of reasonable use of nudge to help students develop scientific eating habits, strengthen school health education, and reduce students' double burden of malnutrition.

Longitudinal associations between smartphone multitasking and depressive symptoms in college students

ZHU Dongqing, TAO Shuman, XIE Yang, WAN Yuhui, WU Xiaoyan, ZOU Liwei, TAO Fangbiao

2024, 45(4): 465-469. doi: 10.16835/j.cnki.1000-9817.2024120

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Objective To explore the longitudinal correlation between smartphone multitasking and depressive symptoms, so as to provide an evidence-based basis for promoting the mental health of college students. Methods A total of 967 college students were recruited from one university in Taiyuan, Chongqing, and Shenzhen cities, China, by using multi-stage randomized cluster sampling from October to December 2021 at baseline, and a follow-up survey was conducted in May 2022. Smartphone multitasking behaviors were assessed by means of the Assessment of Smartphone Multitasking for Adolescents (ASMA), and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) among college students. Chi-square tests were performed to compare the differences in depressive symptoms between different groups of demographic characteristics, and binary Logistic regression models were employed to analyze the associations between smartphone multitasking and depressive symptoms among college students. Results The rates of depressive symptoms among college students at baseline and follow-up were 35.2% and 42.3%, respectively. Compared to the low level smartphone multitasking index group at baseline, the moderate and high level groups were more likely to experience depressive symptoms at baseline (moderate level group: OR=1.74, 95%CI=1.22-2.50, high level group: OR=2.77, 95%CI=1.94-3.95) and follow-up (moderate level group: OR=1.41, 95%CI=1.01-1.95, high level group: OR=1.64, 95%CI=1.17-2.29) (P < 0.05). In addition, compared to the persistently low smartphone multitasking index, increased risk of depressive symptoms was associated with maintaining a moderate-to-high (OR=2.94, 95%CI=1.83-4.71), and a higher (OR=2.07, 95%CI=1.31-3.27) or lower smartphone multitasking index (OR=2.02, 95%CI=1.27-3.19) (P < 0.05). Moreover, higher smartphone multitasking index scores were positively associated with the risk of new-onset depressive symptoms at follow-up (OR=1.87, 95%CI=1.07-3.27, P < 0.05). Conclusions Smartphone multitasking behaviors are find to be associated with an increased risk of depressive symptoms in college students. There is a need to reduce smartphone multitasking in order to decrease depressive symptoms and promote students' mental health.

Association between biorhythm disorders and the co-occurrence of health-risk behaviors in adolescence

ZHAI Yani, WANG Xuelai, WAN Yuhui, TAO Fangbiao, SHEN Juhua, SUN Chongxiu, SUN Lijing, LUO Chunyan

2024, 45(4): 470-474. doi: 10.16835/j.cnki.1000-9817.2024124

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Objective To elucidate the association between biorhythm disorders and health-risk behaviors in adolescence, so as to provide reference for appropriate interventions. Methods From March to April 2023, 2 381 adolescents in Shanghai were selected as research objects using convenience sampling and stratified random cluster sampling methods. The Self-rating Questionnaire of Biological Rhythm Disorders for Adolescents (SQBRDA) and the self-report health-risk behaviors questionnaire were used to investigate the status of adolescent biorhythm disorders and nine kinds of health-risk behaviors, while a multivariate Logistic regression model was employed to analyze the association between the two variables. Results The average SQBRDA score was (68.25±0.42) The incidence and detection rates of health risk behaviors in the groups with no co-occurrence, mild co-occurrence, moderate co-occurrence, and severe co-occurrence were 234(9.83%), 1 176(49.39%), 830(34.86%) and 141(5.92%), respectively. The total SQBRDA score was positively correlated with the risk of co-occurrence of health-risk behaviors. The risk of mild co-occurrence, moderate co-occurrence, and severe co-occurrence of health-risk behaviors was 9.05 times (95%CI=4.25-19.15, P < 0.01), 44.55 times (95%CI=20.75-96.05, P < 0.01) and 110.05 times (95%CI=40.65-297.95, P < 0.01) higher, respectively, among adolescents with higher scores of biorhythm disorders compared to adolescents with lower scores of biorhythm disorders. Conclusions Health-risk behaviors among adolescents in Shanghai draw attention to a serious phenomenon whereby biorhythm disorders are positively correlated with the risk of co-occurrence. Comprehensive interventions aimed at addressing adolescent health-risk behaviors should focus on regulating biorhythm disorders.

Follow-up study of the association between bedroom light at night exposure and body mass index in children

LI Qi, ZHOU Yi, DING Wenqin, ZUO Min, XU Yuxiang, TAO Fangbiao, SUN Ying

2024, 45(4): 475-478. doi: 10.16835/j.cnki.1000-9817.2024121

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Objective To explore the association between bedroom light at night (LAN) exposure and body mass index (BMI) in children at 1-year follow-up, so as to provide new strategies for obesity prevention. Methods From December 2021 to May 2022, cluster random sampling was conducted, involving 648 children from two primary schools in Tianchang, Chuzhou City, Anhui Province, China, to assess bedroom LAN exposure of children during sleep. A questionnaire survey and physical examination were carried out in May 2022. Multivariate linear regression was performed to analyze the correlation between bedroom LAN exposure and BMI variable quantity at 1-year follow-up (May, 2023). Results The median intensity of bedroom LAN exposure during the sleep episode was [1.11(0.35, 3.24)lx] in children. The proportion of the sample exposed to an average light intensity of ≥3 lx was 27.5%, while 19.0% was exposed to a LAN intensity of ≥5 lx during the sleep episode. In the multivariable linear regression, after adjusting for covariates, including sex, baseline age, sleep duration, family monthly income, and maternal education level, exposure to a 1 h-average post-bedtime LAN intensity of ≥3 lx (β=0.25, 95%CI=0.05-0.44) and LAN≥5 lx (β=0.34, 95%CI=0.12-0.55) was associated with a gain of 0.25 and 0.34 kg/m², respectively, in the children's BMI at the 1-year follow-up (P < 0.05). Conclusions A positive correlation was found between bedroom LAN exposure and BMI variable quantity at 1-year follow-up in children. Thus, reduced bedroom LAN exposure might be useful for interventions aimed at obesity prevention.

Status and correlation of neck-shoulder pain, low back pain and mental sub-health among adolescents

HAN Feifei, GAO Xin, XIE Yang, TAO Shuman, WAN Yuhui, TAO Fangbiao

2024, 45(4): 479-482. doi: 10.16835/j.cnki.1000-9817.2024122

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Objective To explore the association among neck-shoulder pain (NSP), low back pain (LBP) and co-occurring symptoms with mental sub-health in adolescents, so as to provide evidence for improving physical and mental health of adolescents. Methods Stratified cluster random sampling method was used to select 7 986 students from 12 middle and high schools in Shenzhen, Nanchang, and Shenyang cities from October to December 2019. The Assessment of Spinal Health of Youth (ASHY) and the Brief Instrument on Psychological Health of Youth (BIOPHY) were used to assess NSP, LBP and mental sub-health. Binary Logistic regression model was used to analyze the association between NSP, LBP and co-occurring symptoms with mental sub-health in adolescents. Results The detection rates of adolescents with NSP, LBP and co-occurring symptoms and mental sub-health were 9.1%, 9.8%, 9.5%, and 10.0%, respectively. The co-occurring rate of neck shoulder pain, low back pain and mental sub-health was 3.2%. After adjusting for confounding variables such as gender, age, being an only child, family residence, and parental education level, NSP (OR=6.01, 95%CI=5.02-7.19), LBP (OR=5.08, 95%CI=4.25-6.07), and co-occurring symptoms (OR=5.96, 95%CI=4.98-7.12) in adolescents were positively correlated with mental sub-health risk (P < 0.01). Stratifying the gender, boys with NSP, LBP and co-occurring symptoms (OR=6.84, 5.80, 6.74)had a higher risk of mental sub-health compared to girls (OR=5.52, 4.65, 5.49) (P < 0.01). Conclusions NSP, LBP and co-occurring symptoms in adolescents are associated with mental sub-health. The mental health status of boys is more affected by NSP, LBP and their co-occurring symptoms. Measures should be taken to improve spinal health in adolescents to reduce the incidence of mental sub-health.

Association between dietary rhythm and depressive symptoms in adolescents

ZHANG Yadi, XIE Yang, WANG Jiaojiao, ZHANG Xinyu, WAN Yuhui, TAO Fangbiao

2024, 45(4): 483-487. doi: 10.16835/j.cnki.1000-9817.2024125

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Objective To describe the prevalence and association of dietary rhythm and depressive symptoms among adolescents, so as to provide a basis for improving unhealthy behavioral habits, and to promote adolescent physical and mental health. Methods From October to December 2021, a total of 22 868 students were selected from one middle school and high school in urban and rural areas of eight cities, namely, Shenyang, Xuzhou, Shenzhen, Taiyuan, Nanchang, Zhengzhou, Chongqing, and Kunming cities, China, using a combination of purposive sampling and stratified cluster random sampling. A self-administered questionnaire was used to assess adolescents' dietary rhythm, and the Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Binary Logistic regression model was employed to analyze the associations between adolescent dietary rhythm and depressive symptoms, while the associations between adolescent dietary rhythm and depressive symptoms across gender and physical activity levels were stratified by gender and physical activity levels. Results The detection rate of depressive symptoms in adolescents was 44.4%. The respective differences in the detection rates of depressive symptoms among adolescents of different genders, physical activity levels, and dietary rhythm disorders were statistically significant (χ²=157.51, 105.02, 3 282.50, P < 0.01). Taking the low disordered dietary rhythm group as the reference, binary Logistic regression analyses showed that after adjusting for confounding factors such as age, gender, family location, family economic situation, whether only-child, parental education level, and learning burden, physical activity levels, depressive symptoms were positively correlated with adolescents in the moderate disordered dietary rhythm group (OR=2.63, 95%CI=2.45-2.83) and the high disordered dietary rhythm group (OR=6.38, 95%CI=5.93-6.86). In addition, after stratifying by gender, dietary rhythm were positively correlated with depressive symptoms. The moderate disordered group (male: OR=2.62, 95%CI=2.37-2.89, female: OR=2.67, 95%CI=2.40-2.97) and the highly disordered group (male: OR=5.74, 95%CI=5.19-6.35, female: OR=7.11, 95%CI=6.40-7.89) were positively correlated with depressive symptoms. After stratification by physical activity levels, low, moderate and above physical activity levels among adolescents in the disordered dietary rhythm group (low physical activity: OR=2.91, 95%CI=2.58-3.29, moderate and above physical activity: OR=2.50, 95%CI=2.28-2.74), high disordered group (low physical activity: OR=6.51, 95%CI=5.94-7.13, moderate and higher physical activity: OR=6.18, 95%CI=5.47-6.97) were positively associated with depressive symptoms (P < 0.01). There was an interaction between dietary rhythm and physical activity levels in regard to the development of depressive symptoms in adolescents, taking the group with moderate and above physical activity levels and low disordered dietary rhythm as the reference, the detection rate of which was higher in adolescents with low levels of physical activity and those in the moderate or high disordered dietary rhythm group (OR=1.50, 3.90, 95%CI=1.39-1.61, 3.63-4.19, P < 0.01). Conclusions Dietary rhythm disorders were found to be positively associated with depressive symptoms in adolescents. Regular dietary behaviors and increased physical activity play an important positive role in promoting adolescent mental health.

Association between anxiety symptoms and social-ecological risk factors among medical students

WANG Kai, YONG Zhongtian, CHEN Jin, ZHU Wenhua, WANG Liyan, WANG Li

2024, 45(4): 488-491. doi: 10.16835/j.cnki.1000-9817.2024104

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Objective To understand anxiety symptoms among medical college students and their relationship with social-ecological risk factors, so as to provide reference for mental health promotion among medical students. Methods From September to October 2021, a convenient cluster sampling method was used to include 1 274 freshmen to senior students of a medical school in Taiyuan City, and the Generalized Anxiety Disorder-7 and adolescent social-ecological risk factors assessment questionnaire were used. Multivariate binary Logistic regression was used to analyze the association between anxiety symptoms and social-ecological risk factors among medical students. Results The overall detection rate of anxiety symptoms among medical students was 16.2%. The rate of anxiety varied significantly by grade (freshman: 19.9%, sophomore: 13.0%, junior: 14.0%, senior: 18.9%) and number of friends (≤2: 22.8%, 3-5: 14.4%, ≥6: 11.8%) (χ²=8.70, 16.34, P < 0.05). Spearman correlation analysis showed that individual, family, school, community, policy, culture, time, and total score in socio-ecological risk factors were positively associated with anxiety symptom scores at different levels of risk (r=0.33, 0.25, 0.32, 0.16, 0.15, 0.16, 0.16, 0.35, P < 0.01). Logistic regression analysis showed that high risk for personal dimension of the socio-ecological risk factors was positively associated with rate of anxiety symptoms among medical students (OR=3.32, 95%CI=1.66-6.61), and remained positively associated (OR=2.98, 95%CI=1.49-5.94) after adjusting for grade and number of friends (P < 0.01). Conclusions Exposure to high personal dimensions of socio-ecological risk factors increases the risk of developing anxiety symptoms among medical students. A focus should be placed on the personal factors associated with anxiety to promote medical students' mental health.

Association of social jetlag and sleep quality with cardiometabolic risk in college students

CHEN Yuming, TAO Shuman, ZOU Liwei, YANG Yajuan, XIE Yang, LI Tingting, ZHANG Dan, QU Yang, ZHAI Shuang, TAO Fangbiao, WU Xiaoyan

2024, 45(4): 492-496. doi: 10.16835/j.cnki.1000-9817.2024116

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Objective To explore the association of social jetlag(SJL) and sleep quality with cardiometabolic risk in college students, so as to provide evidence for improving the physical health of college students. Methods Convenience sampling and cluster sampling method was used to select 318 college students from two universities in Hefei, Anhui Province and Shangrao, Jiangxi Province for questionnaire survey and physical examination from May to June 2021. A self-rated questionnaire was used to investigate the bedtime and wake-up time of college students on weekdays and weekend. SJL was calculated according to the midpoint of sleep on weekdays and weekeng. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality among college students. According to the results of biochemical blood tests, blood pressure and human morphology, the cardiometabolic indexes of college students were determined, and the cardiometabolic risk score was calculated. Mann-Whitney U and Kruskal-Wallis H rank-sum tests were used to compare the differences of cardiometabolic risk scores among college students with different demographic characteristics. Generalized linear models were used to analyze the association between SJL, sleep quality and cardiometabolic risk scores. Results The cardiometabolic risk score for college students was -0.59(-1.85, 1.11). The results of the generalized linear model indicated that both SJL>2 h (β=1.03, 95%CI=0.04-2.03) and poor sleep quality (β=1.67, 95%CI=0.46-2.87) were positively correlated with the cardiometabolic risk score of the college students (P < 0.05). After adjusting for covariates including sex, smoking, alcohol consumption, sleep time type and sleep duration, there were positive correlation between SJL>2 h (β=1.20, 95%CI=0.04-2.03) and poor sleep quality (β=1.82, 95%CI=0.55-3.08) with cardiometabolic risk scores of college students (P < 0.05). Conclusions Higher SJL and poor sleep quality in college students are associated with cardiometabolic risk scores. Measures should be taken to improve circadian rhythm disturbances and sleep quality in college students to reduce the incidence of cardiovascular disease.

A network Meta-analysis of the effects of different exercise modalities on inhibitory control in children with attention deficit hyperactivity disorder

LI Hua, ZHANG Ping, ZHEN Zhiping

2024, 45(4): 497-502. doi: 10.16835/j.cnki.1000-9817.2024100

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Objective To compare the relative effectiveness of different exercise modalities on inhibitory control in children with attention deficit hyperactivity disorder (ADHD), so as to provide an evidence-based basis for the development of effective exercise prescriptions. Methods The databases of China National Knowledge Internet (CNKI), Pubmed, Web of Science, Embase, and Cochrane were searched to screen the literature of randomized controlled trials of exercise interventions for inhibitory control in children with ADHD up to December 31, 2022. The Cochrane risk of bias assessment tool was used for methodological quality assessment, and Stata 17.0 software was used for network Meta-analysis, standardized mean difference (SMD) and 95%CI were used as the effect indicators to compare the difference in effect between interventions and rank the effect. Results Twenty-two papers with a total of 1 134 participants aged 6-14.5 years were finally included. Network Meta-analysis showed that the impact effects of physical and mental exercises [SMD(95%CI)=1.08(0.50-1.66)], cognition+exercise [SMD(95%CI) =0.81(0.13-1.48)], and ball games [SMD(95%CI)=1.54(0.99-2.09)] were significantly superior to that of control group, and the ball games had a significantly better effect than single aerobic exercise [SMD(95%CI)=1.02(0.20-1.84)], and combined exercises [SMD(95%CI)=1.08(0.28-1.88)](P<0.05). The results of surface under the cumulative ranking (SUCRA) showed that ball games might be the best means to improve inhibitory control in children with ADHD(SUCRA=95.3). Conclusion It is recommended to appropriately increase ball sports in sports activities to more effectively improve the inhibitory control of children with ADHD.

MA Caixia, YANG Tian, ZHANG Xiuhong, GAO Sheng, MA Xinyue

2024, 45(4): 503-508. doi: 10.16835/j.cnki.1000-9817.2024103

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Objective To analyse associated factors of campus bullying in schools, and to construct a nomogram model to predict the risk of campus bullying, so as to provide a theoretical basis for campus bullying prevention and control. Methods In September 2023, 89 117 middle and high school students were selected by stratified cluster random sampling method within 12 cities (103 counties) in Inner Mongolia, and were surveyed with self-administered questionnaire. Among them, there were 62 381 participants in the training set and 26 736 participants in the testing set. Statistical analysis was conducted using χ² test and multiple Logistic regression, and a nomogram model was drawn for predicting campus bullying. Results The prevalence of campus bullying was 3.49%. Living in a suburban county, living in an unstable family, not the only child, having a father with a college degree or above, sometimes or never eating breakfast, being overweight or obese, living on campus, being scolded by parents in the past 30 days, smoking, Internet addiction, experiencing depression, anxiety symptoms, recreational soluble solvents use, cough medicine abuse, nonprescribed use of sedatives were all positively correlated with campus bullying (OR=1.18, 1.40, 1.12, 1.33, 1.13, 1.72, 1.12, 1.17, 1.82, 1.32, 1.83, 3.92, 2.40, 2.25, 1.51, 1.63, P < 0.01).There were a negative correlation between high school students, female students, and the number of physical education classes per week (2-3, ≥4) with campus bullying (OR=0.67, 0.58, 0.72, 0.83, P < 0.01). The prediction model of campus bullying risk was established by nomogram model. The area under curve (AUC) was 0.82, and the calibration curve showed that the predicted value was close to the actual value. Conclusions Bullying among middle and high school students are related to family intimacy, poor daily behaviour and psychological factors. Targets of bullying intervention in schools should be identified, and preventive and control measures against bullying in secondary schools should be formulated, so as to reduce the occurrence of campus bullying.

Latent classes of health-risk behaviors and their association with school connectedness among adolescents in the Wuling Mountain Area

ZHANG Tiancheng, ZHOU Xianwei, XU Tao, ZHANG Fulan, WANG Aolun

2024, 45(4): 509-513. doi: 10.16835/j.cnki.1000-9817.2024127

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Objective To understand the potential categories of health-risk behaviors among adolescents in the Wuling Mountain Area and their association with school connectedness, so as to provide reference for formulating classified and effective intervention measures. Methods From March to June 2023, 3 386 middle and high school students from eight schools in the Wuling Mountain Area were selected using the multistage stratified cluster random sampling method. A basic information questionnaire, health-risk behaviors questionnaire, and school connectedness scale were utilized for the survey. The latent classes of adolescent health-risk behaviors in the Wuling Mountain Area were investigated by using latent class analysis, while an multinomial Logistic regression model was employed to analyze the association between latent classes and school connectedness. Results Adolescent health-risk behaviors in the Wuling Mountains Area were classified into three latent classes: high-risk class of episodic behaviors (5.64%), high-risk class of implicit behaviors (26.90%), and low-risk class of implicit behaviors (67.45%). Gender, ethnicity, and family type revealed significant differences in the distribution of the three latent classes (χ²=117.91, 22.55, 21.51, P < 0.05). The results of the regression model analysis showed that, with the low-risk class as the reference category, high school connectedness scores were associated with the high-risk class of episodic behaviors (OR=0.89, 95%CI=0.88-0.91) and the high-risk class of implicit behaviors (OR=0.90, 95%CI=0.89-0.91)(P < 0.05). Conclusions The characteristics of adolescent health-risk behavior classes in the Wuling Mountain Area are obvious. The high-risk class of episodic behaviors and the high-risk class of implicit behaviors are negatively correlated with school connectedness. Corresponding measures should be taken to enhance adolescents' sense of belonging in school and reduce the aggregation and co-occurrence of health-risk behaviors.

Association between screen time and internalizing and externalizing behavioral problems in primary and secondary school students in Shanghai

WANG Honghui, TONG Lian

2024, 45(4): 514-519. doi: 10.16835/j.cnki.1000-9817.2024128

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Objective To explore the association between screen time and internalizing and externalizing behavioral problems of primary and secondary school students, so as to provide reference for early intervention of internalizing and externalizing behavioral problems of children and adolescents. Methods Using stratified random cluster sampling method, 2 178 primary and secondary school students were sampled in October to December, 2021 in Shanghai, China, and were surveyed by using the Strengths and Difficulties Questionnaire and the self-administered screen time questionnaire. The χ² test and multifactor Logistic regression model were used to analyze the association between screen time and internalizing and externalizing behaviors of primary and secondary school students. Results The detection rates of internalizing and externalizing behavior problems among primary and secondary school students were 20.5% and 23.7%, respectively. Boys were reported of higher rates of watching TV and playing games ≥2 h/d(9.2%, 3.0%) than girls (5.2%, 1.2%) (χ²=11.95, 8.15, P < 0.01). After adjusting for variables such as sex, students' age, annual family income, parental age, parental educational level, and only child status, cell phone use ≥2 h/d increased the risk of internalizing problems in primary and secondary school students (OR=2.40, 95%CI=1.53-3.79), screen time ≥2 h/d on study days increased the risk of internalizing and externalizing behavioral problems in primary and secondary school students [OR(95%CI)=1.93(1.38-2.69), 1.63(1.14-2.32)] (P < 0.05). Conclusions Excessive screen time is associated with the development of internalizing and externalizing behavior problems in children and adolescents. It is suggested to control the screen time of primary and secondary school students reasonably.

Analysis of depressive symptoms and influencing factors among middle and high school students from 2018 to 2021 in Zhejiang Province

GU Fang, YANG Ying, ZHENG Weijun, MENG Jia, LI Juanjuan, SHEN Yu, GAO Lei, ZOU Yan, ZHANG Ronghua

2024, 45(4): 520-524. doi: 10.16835/j.cnki.1000-9817.2024105

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Objective To investigate the prevalence and associated factors of depressive symptoms among middle and high school students in Zhejiang Province, so as to provide scientific basis for the implementation of depressive intervention. Methods Based on the health status and associated factors of middle and high school students in the project "Monitoring of Common Diseases and Health Influencing Factors of Students" during 2018 to 2021, a total of 73 309 students including middle school, ordinary high school and vocational high school surveyed in 11 cities of Zhejiang Province were selected by multi-stage stratified cluster random sampling method. From 2018 to 2021, there were 6 008, 21 917, 23 712 and 21 672 students, respectively. The Chi-square test and Logistic regression model were used to analyze the influencing factors of depressive symptoms in middle and high school students. Results From 2018 to 2021, depressive symptoms detection rate of middle school students was 14.8%, with higher rate in girls (17.1%) than in boys (12.7%), higher rate in high school (17.1% in ordinary high school, 17.6% in vocational high school) than middle school (12.5%)(χ²=278.77, 327.22, P < 0.05). Univariate analysis showed that there were statistically significant differences in depressive symptoms detection rate among middle school students with different years (2018: 16.7%, 2019: 17.9%, 2020: 13.1%, 2021: 13.0%), residence (yes: 16.3%, no: 13.5%), body mass index classification (not overweight or obesity: 14.8%, overweight: 14.2%, Obesity: 15.7%), weekly exercise days (0-2 d: 17.1%, 3-5 d: 12.5%, 6-7 d: 13.1%) and bullying (yes: 35.5%, no: 10.7%) (χ²=293.40, 118.35, 7.83, 287.24, 4 978.84, P < 0.05). Multivariate Logistic regression analysis showed that female students, ordinary high schools, vocational high schools, obesity, school bullying were positively correlated with depression (OR=1.65, 1.70, 1.60, 1.12, 5.21), exercise 3 to 5 days per week, exercise 6 to 7 days per week were negatively correlated with depression (OR=0.77, 0.81, P < 0.01). Conclusions Depressive symptoms among middle and high school students in Zhejiang Province are prominent. Strengthening mental health education for students and providing attention and support from families, schools, and society are essential steps to reduce the occurrence of depressive symptoms among these students.

Impact of parental divorce on psychological abuse and neglect among middle and high school students

REN Xiaohong, LIN Cen, CEN Yu, HE Ping, LUO Jiaming

2024, 45(4): 525-529. doi: 10.16835/j.cnki.1000-9817.2024117

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Objective To investigate how parental divorce impacts psychological abuse and neglect among middle and high school students, so as to provide evidence for the development of family intervention strategies for mental health promotion. Methods A stratified random cluster sampling method was employed to select students from 23 middle and high schools in Nanchong, Neijiang, and Luzhou. Online questionnaires utilizing the General Data Questionnaire and the Child Psychological Abuse and Neglect Scale (CPANS) were administered. Propensity-score matching (PSM) was used to compare individual characteristics between parent-divorce and the control groups. The χ² test was then employed to analyze differences in psychological abuse and neglect across variables, with Logistic regression used to treat psychological abuse and neglect as dependent variables. Results After PSM, there were 1 898 cases in both parent-divorce and control groups. There was no significant difference in gender composition between the two groups (χ²=0.03, P>0.05). Compared to the control group, after controlling for various factors including gender, phase of studying, parental education, whether to live in school, and long-term caregivers of the student, the risk of experiencing psychological abuse (OR=1.43, 95%CI=1.26-1.63) and neglect (OR=1.53, 95%CI=1.33-1.75) was significantly higher in parent-divorce group (P < 0.05). Conclusions Parental divorce significantly impacts psychological abuse and neglect experienced by middle and high school students. Therefore, support and intervention efforts should be intensified for students from divorced or unstable marriage families.

Association between parental control, peer relationship and aggressive behavior in junior high school students

HAN Wengeng, QI Zhiyuan, ZHAO Jili, NI Hong, CHENG Yaohui, HAN Hui

2024, 45(4): 530-534. doi: 10.16835/j.cnki.1000-9817.2024112

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Objective To understand the interrelationships of parental control, peer relationship, and aggressive behavior in junior high school students, in order to provide a theoretical basis for preventing the occurrence of adolescent aggressive behavior. Methods During June to July, 2022, 2 564 students of grade one to grade three were selected from 6 junior high schools from each of Suzhou and Xuancheng cities in Anhui Province by using convenient cluster random sampling method, and then the questionnaire survey was administered, including the Chinese version of Parent Control Questionnaire, Chinese version of Buss & Perry Aggression Questionnaire and Adolescent Peer Relationship Questionnaire. Results Boys scored (185.31±27.49, 21.65±7.43, 21.77±8.18, 69.50±11.41, 72.39±11.53) higher than girls (178.21±25.13, 20.08±7.09, 20.61±7.62, 66.56±11.14, 70.95±11.84) in parental control, father's psychological control, mother's psychological control, father's behavioral control, and mother's behavioral control (t=8.63, 5.47, 3.70, 6.60, 3.12), while girls scored (48.41±11.26) higher in peer relationship than boys (47.13±10.84) (t=-2.95) (P < 0.01). The scores of first-grade-students in parental control, father's psychological control, mother's psychological control, father's behavior control, peer relationship, and aggressive behavior (184.67±27.18, 21.83±7.29, 22.15±8.07, 68.81±10.95, 50.21±9.57, 80.23±17.66) were higher than those of second-grade-students (180.98±25.46, 20.16±7.82, 20.21±7.55, 68.29±11.69, 45.47±11.67, 74.08±17.70) and third-grade-students (179.21±26.79, 20.53±7.22, 21.17±8.06, 66.81±11.39, 47.54±11.43, 75.75±16.29) (F=9.44, 12.87, 13.61, 6.84, 42.85, 30.40, P < 0.01). The scores of parental control and peer relationship were positively correlated with the scores of aggressive behavior (r=0.22, 0.47, P < 0.01). Peer relationship partially mediate the relationship between parental control and aggressive behavior, with a partial mediation effect value of 0.04, accounting for 26.39% of the total effect of parental control on aggressive behavior. Conclusions High parental control and poor peer relationship are both positively correlated with the level of aggressive behavior. The peer relationship of teenagers should be improved by establishing appropriate parenting style, tackling campus violence, and maintaining good social norms, in order to reduce the occurrence of aggressive behavior among adolescents.

Investigation on loneliness and negative emotional symptoms among first-generation college students in the family

FENG Huiyan, ZENG Zhuwei, LUO Xiaohong, HUANG Hongqing, ZHAO Haipeng, ZENG Hong

2024, 45(4): 535-538. doi: 10.16835/j.cnki.1000-9817.2024119

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Objective To investigate the current status and relationship between loneliness and negative emotional symptoms among first-generation college students in the family, so as to provide reference for improving mental health of this population. Methods A convenience sampling method was used to select 3 017 college students from 10 colleges and universities in Guangdong Province and Yunnan Province, China, in May 2023. Questionnaires were administered to the students, and the Depression Anxiety Stress Scale (DASS-21) and the short-form of the University of California at Los Angeles Loneliness Scale (ULS-6) were employed. Results The total ULS-6 score of first-generation college students in the family was (12.38±4.16), while the score of non-first-generation college students in the family was (11.89±4.38), with a statistically significant difference (t=2.79, P < 0.05). The total DASS-21 score of first-generation college students in the family was (71.13±26.97), while the score of non-first-generation college students in the family was (70.20±26.66), with a statistically significant difference (t=2.69, P < 0.05). Among the first-generation college students in the family, male students experienced more DASS-21 score (77.55±29.36) than female students (70.43±25.03)(t=5.79, P < 0.05). Urban students (12.00±4.15, 70.34±25.68) reported lower levels of loneliness score and DASS-21 score than rural students (12.62±4.15, 74.93±27.63), and the depression subscale scores showed statistically significant differences among students with different professional achievement rankings (t/F=-3.42, -3.94, 4.25, P < 0.05). There was a positive correlation between loneliness, depression, anxiety, pressure and DASS-21 scales of first-generation college students in the family (r=0.64, 0.62, 0.64, 0.66,P < 0.01). The linear regression analysis results showed a positive correlation between loneliness and all dimensions and total scores of the DASS-21, explaining 44% of the variance in negative emotional symptoms. Conclusions A positive correlation is found between loneliness and negative emotional symptoms among first-generation college students in the family. Improving the loneliness of the first-generation college students in the family can reduce their negative emotional symptoms and improve their mental health level.

Impact of multi-sensory stimulation intervention on the psychological state, neurobiology, and neuroelectrophysiological indicators of college students with Internet addiction

LI Ke, YANG Kunpeng, ZHANG Shanshan

2024, 45(4): 539-543. doi: 10.16835/j.cnki.1000-9817.2024102

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Objective To observe the effects of multi-sensory stimulation (MSS) intervention on the psychological state, neurobiology, and neuroelectrophysiological indicators of college students with Internet addiction disorder (IAD), so as to provide high-quality evidence for the optimization of IAD intervention plans. Methods At the beginning of the spring semester of 2022-2023 academic year, 114 first-year and sophomore IAD college students from Chongqing Second Normal University were selected by group random sampling method, and were randomly assigned into control group, physical exercise group, and observation group (28 in each group). The control group received routine psychological intervention, while the physical exercise group received routine physical exercise on the basis of the control group. The observation group received a MSS intervention on the basis of the control group. The MSS intervention included 8 means of color, incense, music, lozenges, press needle, massage, Tai Chi and static work. The intervention periocl was from April 1 to June 30, 2023, and all three groups were intervened for 12 weeks. The revised Chinese Internet Addiction Scale (CIAS-R), Self Control Scale (SCS), Symptom Checklist-90 (SCL-90) were observed before and after intervention, dopamine (DA) and β-Endorphin (β-EP) concentration were collected, and the amplitude and latency levels of N200 were analyzed by Event Related Potential (ERP). Results The CIAS-R score of the observation group (36.08±4.98) was lower than physical exercise group (49.55±5.19) and control group (54.82±4.10), and the SCS score of the observation group (76.08±1.98) was higher than physical exercise group (66.16±1.92) and control group (52.59±1.53) (F=12.08, 13.18, P < 0.05). In comparison of various dimensions of SCL-90, the observation group showed lower scores in the four dimensions of somatization, depression, anxiety, and psychoticism compared to the other two groups (F=9.11, 8.92, 8.17, 8.48, P < 0.05). In the dimensions of obsessive-compulsive symptoms, interpersonal sensitivity, and others in observation group were lower than the control group (F=4.20, 5.16, 5.60, P < 0.05). However, there was no difference in the two dimensions of terror and paranoia among the three groups (F=0.24, 0.19, P>0.05). The levels in plasma DA, β-EP and the amplitude and latency of N200 among observation group were better than other two groups, and the differences were statistically significant (F=9.92, 8.93, 6.24, 8.05, P < 0.05). Conclusion MSS intervention can alleviate the related symptoms of IAD college students, improve neurobiological and neurophysiological indicators.

Longitudinal relationship between social avoidance and distress, learning burnout, school adaptation and depression among high school students

TANG Tiangui, LUO Hao, YUAN Zeliang, PENG Xiaofan, PAN Yangu

2024, 45(4): 544-548. doi: 10.16835/j.cnki.1000-9817.2024101

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Objective To examine the influence of school adaptation on depression among high school students, as well as the mediating effects of social avoidance and distress and learning burnout on the relationship between school adaptation and depression among high school students, so as to provide a basis for the mental health promotion among high school students. Methods A convenience sampling method was used to select 1 207 first-year high school students from two high schools as the research subjects in Guiyang City. The School Adaptation Scale(SAS), Social Avoidance and Distress Scale(SAD), Learning Burnout Questionnaire(LBQ), Patient Health Questionnaire-9(PHQ-9) were used to conduct surveys at three time points: October 2021 (T1), May 2022 (T2), and March 2023 (T3). Common method biase was tested using the Harman's single-factor method, and bias correction was conducted via the Bootstrap method, utilizing 5 000 resamples to analyze the 95% confidence intervals(95%CI) of parameter estimates. Results School adaptation at T1 was negatively associated with depression of high school students at T3 (β=-0.13, P<0.01). The mediation analysis showed that the mediating effect of social avoidance and distress at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.100 (95%CI=-0.134-0.071, P<0.05). The mediating effect of learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.157 (95%CI=-0.211-0.106, P<0.05). The chain mediation effect of social avoidance and distress and learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was -0.022 (95%CI=-0.037-0.012, P<0.05). Conclusions Good school adaptation can directly alleviate depressive mood, and can indirectly reduce depression through social avoidance and distress and learning burnout among high school students. Families and schools should pay attention to the school adaptation of high school students and provide timely interventions and assistance to students with poor adaptation.

Effectss of persistent obesity on lung function in school-age children

DING Jiayun, ZHANG Boya, DAI Yiming, WANG Zheng, GUO Jianqiu, DUAN Zhiping, ZHANG Qinyu, QI Xiaojuan, WU Chunhua, ZHANG Jiming, ZHOU Zhijun

2024, 45(4): 549-553. doi: 10.16835/j.cnki.1000-9817.2024107

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Objective To analyze the impact of persistent obesity on their lung function, so as to offer insights for implementing intervention measures to increase lung function in obese school-age children. Methods A total of 335 children from the Sheyang Mini Birth Cohort established in 2009 in Yancheng City, Jiangsu Province, who participated in the follow-up at the ages of 7 years (2016) and 10 years (2019), were selected as the study participants. Physical measurements including height, weight, and lung function were recorded. According to the World Health Organization standard, that is, gender- and age-specific to correct the body mass index to calculate the body mass index Z score, was used to evaluate the obesity status of children at the age of 7 and 10. Children were divided into four groups, including sustained non-obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Meanwhile, the lung function prediction equations recommended by the Global Lung Function Initiative were used to standardize the lung function indexes of children. Pulmonary function differences among these groups were examined, and the relationship between childhood obesity and pulmonary function was longitudinally analyzed using generalized estimating equations. Results The prevalence of obesity were 9.0% and 16.1% at the age of 7 and 10 years, respectively. The proportion of both newly classified and persistent obesity group were 8.1%, respectively. The forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) were (1 269.90±202.70) and (1 415.70±230.00) mL, respectively, at the age of 7 years. FEV₁ and FVC at the age of 10 years were (1 440.80±403.20) and (1 555.60±517.60) mL, respectively. Cross-sectional analysis at age 7 showed that forced expiratory flow at 75% vital capacity (FEF₇₅) (β=-0.52, 95%CI=-0.96-0.07) and maximal mid-expiratary flow (MMEF) (β=-0.45, 95%CI=-0.89-0.00) were significantly lower in obese children compared to their non-obese peers (P<0.05). Longitudinal analysis indicated that obese children had lower levels of lung pulmonary function, with a statistically significant difference in FEV₁ (β=-0.44, 95%CI=-0.85-0.02, P<0.05). There was no significant difference among the various obesity groups (P>0.05), while gender-stratified results revealed significant reductions in FEV₁/FVC in newly classified obese girls at age 10 years (β=-1.76, 95%CI=-3.13-0.38) and in MMEF in persistently obese girls at age 10 years (β=-1.44, 95%CI=-2.79-0.09) (P<0.05). Conclusion Obesity may contribute to reduced lung function levels in school-aged children, with newly classified and persistent obesity having more pronounced effects on lung function in girls.

Longitudinal association between mobile phone dependence and depressive symptoms in Yunnan college students

TAO Jian, LIU Yueqin, YANG Pin, YANG Jieru, WU Houyan, ZHOU Feihui, PAN Lijuan, XU Honglü

2024, 45(4): 554-559. doi: 10.16835/j.cnki.1000-9817.2024114

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Objective To analyze the longitudinal association between mobile phone dependence and depressive symptoms in college students, so as to provide a theoretical basis for psychological health education among college students. Methods From November 2021 to June 2023, 2 515 first-year students from 2 universities in Yunnan Province were surveyed with a questionnaire by a cluster random sampling method, including baseline survey (November 2021, T1) and three follow-up visits (June 2022, T2; November 2022, T3; June 2023, T4). The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use and the Depression Anxiety Stress Scales-21 (DASS-21) were used to evaluate mobile phone dependence and depressive symptoms of college students. The χ² test was used to analyze the difference in depressive symptoms among different demographic groups, and a generalized estimation equation model was established to analyze the association between mobile phone dependence symptoms and depressive symptoms. Results The detection rates of depressive symptoms among university students in Yunnan Province at time points T1, T2, T3, and T4 were 23.02%, 33.36%, 34.79% and 35.51%, respectively. There were statistically significant differences in the detection rates of depressive symptoms among college students with different sacademic burden (T1, T2, T3, T4), different number of close friends (T1, T2, T3), as well as their father's educational level (T1), mother's educational level (T2, T4), gender (T4), major (T3, T4), education (T2, T3, T4), family residency (T1, T2), and family economic conditions (T1, T2, T4) (χ²=59.68, 49.38, 16.70, 39.31; 55.35, 26.01, 16.69; 10.22; 14.87, 11.51; 14.90; 27.81, 50.28; 9.75, 7.42, 24.76; 6.06, 4.47; 15.88, 14.58, 15.85, P<0.05). After controlling for demographic variables and confounding factors in the generalized estimation equation model, mobile phone dependence (β=0.11), withdrawal symptoms of mobile phone dependence (β=0.14), and the physical and mental effects of mobile phone dependence (β=0.14) were all positively correlated with depressive symptoms (P<0.01). Further gender analysis showed that depressive symptoms in both boys (β=0.13, 0.13, 0.18) and girls (β=0.10, 0.13, 0.13) were associated with mobile phone dependence, withdrawal symptoms of mobile phone dependence and the physical and mental effects of mobile phone dependence (P<0.01). Conclusions Depressive symptoms of college students are positively correlated with mobile phone dependence, and family economic conditions, academic burden and number of close friends are factors that continued to affect depressive symptoms. College students should be guided to pay attention to the impact of excessive use of mobile phones on their physical and mental health, use mobile phones reasonably to reduce the incidence of depressive symptoms among college students.

Longitudinal associations between organophosphate esters exposure and blood pressure among school-aged children in Beijing

XIAO Huidi, LI Menglong, ASIHAER Yeerlin, GUAN Mengying, ZOU Yuchen, ABUDUMIJITI Tuerxunayi, ZHAO Ruilan, HU Yifei

2024, 45(4): 560-564. doi: 10.16835/j.cnki.1000-9817.2024129

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Objective To explore the longitudinal association between organophosphate esters (OPEs) exposure and blood pressure in children, so as to provide a reference for identifying the effects of OPEs exposure on child health. Methods A total of 404 children from the Beijing Child Growth and Health Cohort (PROC) were enrolled using a case cohort study design, baseline physical examination, urine collection, questionnaires survey were administered in 2018 and follow-up surveys in 2019-2020 and 2023. Participants were divided into case group (n=140) and control group (n=264) according to the observation of new onset of high blood pressure during the follow-up period. High performance liquid chromatography-tandem mass spectrometry was used to detect diethyl phosphate (DEP), bis (2-chloroethyl) phosphate (BCEP), bis (1-chloro-2-propyl) phosphate, (BCIPP), diphenyl phosphate(DPHP), dibutyl phosphate (DnBP), bis (1, 3-dichloro-2-propyl) phosphate(BDCIPP), bis(2-butoxyethyl) phosphate(BBOEP), bis (2-butoxyethyl) 2-hydroxyethyl phosphate (BBOEHEP), 4-hydroxyphenyl diphenyl phosphate (4-OH-TPHP). Generalized linear mixed models and Quantile g-computation models were developed to analyze the longitudinal associations between OPEs individual/mixed exposure and blood pressure in children. Results The detection range of 9 OPEs metabolites, including DEP, BCEP, BCIPP, DPHP, DnBP, BDCIPP, BBOEP, BBOEHEP and 4-OH-TPHP at three time points (baseline, first follow-up and second follow-up) were 27.7%-92.1%, 24.0%-99.3% and 39.2%-90.9% respectively. Without adjustment for covariates such as gender, age, body mass index, Tanner stage, parental education, and monthly household income, and family history of hypertension, the increase of BDCIPP concentration and mixed exposure of OPEs may reduce children's systolic blood pressure(β=-0.85, -2.40, 95%CI=-1.69-0.01, -3.30-1.50, P<0.05). After adjusting for the covariates, the longitudinal association of individual OPEs or mixed exposure with pediatric BP was not statistically significant (P>0.05). Conclusion Children are commonly exposed to OPEs, and although no significant longitudinal associations are observed between exposure to OPEs and blood pressure among school-aged children in Beijing, it is recommended that child exposure should be minimized whenever possible.

Co-occurrence of campus bullying and suicidal tendency and its correlation with addictive behavior among middle and high school students in Hainan Province

SHAO Zhixiao, GENG Xiulai, ZOU Jinting, WANG Wenhao, ZHANG Dongxian

2024, 45(4): 565-569. doi: 10.16835/j.cnki.1000-9817.2024113

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Objective To investigate the correlation between campus bullying and suicidal tendency symptoms comorbidity with addictive behavior among middle and high school students in Hainan Province, so as to provide a theoretical basis for health education and behavioral intervention in schools. Methods In July 2023, an anonymous questionnaire survey was conducted among 6 654 middle and high school students in Hainan Province, selected by probability proportional sampling and stratified cluster random sampling method. Campus bullying, suicidal tendency and addictive behavior were determined according to the relevant items in the questionnaire on health related behaviors of Chinese students' health status and influencing factors questionnaire, and self-designed questionnaire. The co-occurrence of campus bullying and suicidal tendency among students was analyzed. The binary Logistic regression method was used to analyze the correlation between the co-occurrence of campus bullying and suicidal tendency and the addictive behavior of middle school students. Results The report rate of campus bullying among middle and high school students in Hainan Province was 28.48%, the suicidal tendency was 15.25%, and the co-occurrence of campus bullying and suicidal tendency was 8.00%. The results of Logistic regression analysis showed that middle school students and left-behind students were prone to campus bullying and suicide tendency (OR=1.55, 1.52, P<0.05), while Internet addiction, gambling and current smoking showed significant positive correlation with comorbidity of campus bullying and suicide tendency (OR=3.14, 2.18, 2.07, P<0.05). Conclusions Middle and high school students with addictive behavior have a higher possibility of comorbidity of campus bullying and suicidal tendency. The comprehensive intervention of addictive behavior can reduce the incidence of co-occurrence of campus bullying and suicidal tendency, so as to improve health and wellbeing of middle school students.

Relationship between new surrogate marks of insulin resistance and bone mineral content in adolescents

MA Xiaoyan, TIAN Mei, LIU Jianxi, TONG Lingling, DING Wenqing

2024, 45(4): 570-574. doi: 10.16835/j.cnki.1000-9817.2024106

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Objective To analyze the relationship between new surrogate marks of insulin resistance (IR) and bone mineral content (BMC) in adolescents, and predictive value of the new surrogate marks on low bone mass, so as to provide scientific basis for early identification and prevention of skeletal-related diseases in adolescents. Methods A total of 1 594 adolescents aged 12-18 years in Yinchuan City were selected by convenience sampling and stratified cluster random sampling from September 2017 to September 2020, and triglyceride and glucose index (TyG), triglyceride glucose-body mass index (TyG-BMI) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) were calculated as new simplified IR index. The correlation between different simplified IR indexes and BMC level was analyzed by partial correlation. Binary Logistic regression was used to analyze the relationship between IR index and low bone mass, and receiver operating characteristic (ROC) curve was constructed to analyze its evaluation effect on low bone mass. Results After adjusting for confounding factors such as gender, age, smoking, drinking, family history of hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP), the new surrogate marks of IR were positively correlated with BMC level (TyG: r=0.11, TyG-BMI: r=0.58, TG/HDL-C: r=0.21, P<0.01). After further adjustment of body mass index (BMI), fat mass (FM) and lean mass (LM), the relationship between IR indexes and BMC turned into negative correlation (TyG: r=-0.20, TyG-BMI: r=-0.18, TG/HDL-C: r=-0.14, P<0.01). After adjusting for confounding factors such as gender, age, smoking, drinking, family history of hypertension, SBP and DBP, Logistic regression results showed that the increase of TyG, TyG-BMI and TG/HDL-C levels reduced the possibility of low bone mass in adolescents (TyG: OR=0.63, 95%CI=0.40-0.98, TyG-BMI: OR=0.94, 95%CI=0.93-0.96, TG/HDL-C: OR=0.31, 95%CI=0.17-0.58, P<0.01). After adjusting BMI, FM and LM, the above results were completely reversed. Girls with high TyG and TG/HDL-C levels were 4.95 and 4.38 times more likely to have low bone mass than those with low TyG and TG/HDL-C levels (TyG: OR=4.95, 95%CI=1.29-18.95, TG/HDL-C: OR=4.38, 95%CI=1.04-18.50, P<0.05). ROC curve showed that TyG-BMI had the best predictive value on low bone mass (AUC=0.80, 95%CI=0.77-0.83, P<0.01). Conclusion The new surrogate marks of IR in adolescents are negatively correlated with adolescent BMC, of which TyG-BMI is the best for assessing of low bone mass and can serving as a reliable indicator for early identification of low bone mass.

Establishment of a risk prediction model for poly-victimization among rural left-behind children

LUO Yandong, CHANG Ping, ZHOU Jiajun, CAO Zicheng, LI Liping

2024, 45(4): 575-580. doi: 10.16835/j.cnki.1000-9817.2024126

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Objective To construct a risk prediction model for poly-victimization (PV) among rural left-behind middle and high school students in Chaoshan, and to evaluate the prediction effect of the model, so as to provide scientific basis for early identification and prevention of PV among students. Methods A questionnaire survey was conducted among 1 005 left-behind students, selected from 7 middle and high schools in rural areas of Shantou City and Jieyang City by a stratified random cluster sampling method from January 2020 to September 2021, for the personal, family, external environmental factors, psychological factors (mental resilience, coping approaches, self-esteem and social support) and PV situations. R software and Logistic regression were used to screen predictor variables to build a risk prediction model, and the area under the ROC curve (area under the curve, AUC), accuracy, precision, recall, F1 value and calibration curve were used to evaluate the model's effect. Results The incidence rate of PV among left-behind middle and high school students was 23.38%. The results of Logistic regression analysis showed that physical illness or disability (β=1.02), grade retention during the past year (β=1.31), having no close partner (β=1.00), self-harm intention (seldom: β=0.58, occasionally: β=0.79), negative peer behavior (β=0.90), family member smoking (β=0.59), criminal offenses of parents (β=1.04), witnessing school bullying (β=0.78), house moving (β=0.58), using venting (β=0.34) and the coping style of patience (β=0.28) were positively correlated with PV among left-behind children in Chaoshan area, and family support in psychological flexibility (β=-0.31) was negatively correlated with PV (P<0.05). A nomogram prediction model was constructed for the meaningful variables included in the multivariate analysis, and the prediction model AUC was 0.88, the accuracy was 82.00%, the precision was 77.78%, and the F1 value was 43.75%. The calibration plot fitted well, and the model had good discrimination and calibration. Conclusion The risk prediction model for left-behind middle and high school students with PV has good predictive performance and is helpful for schools and communities to early identify high-risk middle and high school students with PV.

Relationship between metal exposure and blood pressure in rural primary school students in Shiyan City, Hubei Province

YAN Tinghua, FANG Wen, LI Junmin, ZHANG Yao, LU Yu, ZHANG Miao

2024, 45(4): 581-584. doi: 10.16835/j.cnki.1000-9817.2024109

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Objective To explore the relationship between metal exposure level and blood pressure, so as to provide a scientific basis for verifying the relationship between metal exposure and elevated blood pressure among primary school students. Methods In July 2022, a total of 555 students of second to sixth grade were selected by cluster random sampling method from two primary schools in Zhuxi County, Shiyan City, Hubei Province. A questionnaire survey was conducted to obtain the socio-demographic characteristics and living habits of the participants. The height, weight, body mass index(BMI) and blood pressure were obtained by physical examination. At the same time, the urine of the subjects was collected, and the metal mass fraction in urine was detected by inductively coupled plasma mass spectrometry. The relationship between metal mass fraction in urine and blood pressure was analyzed by generalized linear regression. Results The detection rate of elevated blood pressure in primary school students was 15.86%, and there was a statistically significant difference in the detection rate of elevated blood pressure among obese primary school students (yes: 37.25%, no: 13.69%, χ²=19.28, P < 0.01).There were statistically significant differences in BMI[15.80(14.69, 17.92), 17.87(15.49, 20.89)kg/m²] between the non elevated blood pressure group and the elevated blood pressure group of elementary school students (Z=-4.67, P < 0.01). The geometric mean mass fraction of zinc in urine was the highest (6 942.86 μg/g), titanium was the lowest (2.20 μg/g). Zinc and lead were positively correlated with elevated systolic blood pressure(β=0.054, 0.014), zinc and cadmium were positively correlated with elevated diastolic blood pressure (β=0.038, 0.029) (P < 0.05). Conclusions Metal zinc, lead and cadmium concentration are associated with elevated blood pressure. It is necessary to intervene and control the exposure of zinc, lead and cadmium in the environment to promote the blood pressure health of primary school students.

Analysis of case characteristics of physical assault injuries surveillance among students in Dalian, 2018-2020

ZHOU Yiheng, ZHANG Yu, LIN Hong

2024, 45(4): 585-588. doi: 10.16835/j.cnki.1000-9817.2024108

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Objective To understand the epidemiological characteristics of physical assault injuries among students in Dalian, so as to provide evidence for the prevention and control of physical assault injuries among students. Methods Data of student physical assault injuries came from the Dalian Hospital Injury Monitoring System from 2018 to 2022, descriptive epidemiological methods and Chi-square tests were used for statistical analysis. Results A total of 1 413 cases of physical assault injuries among students were reported, and the sex ratio between male and female was 4.12∶1. The number of reported physical assault injuries dropped from 414 cases in 2018 to 209 cases in 2022. The group of senior middle school/secondary vocational school had the highest proportion of cases (40.13%). Injuries occurred in all months, with the highest number of reported cases in June, October, and November, accounting for 33.97%. The main causes of injuries were blunt instrument injuries and falls, accounting for 70.06% and 23.35% respectively. The proportion of male (71.24%) was significantly higher than female (65.22%) in blunt instrument injuries (χ²=3.84, P < 0.05). Nearly 75.58% of injuries occurred during leisure time. The main locations of injuries took place in schools and roads, accounting for 51.52% and 23.35% respectively. Contusions and sharp instrument injuries were one of the most common types of injuries, accounting for 67.16% and 22.29% respectively. The main area of injury was concentrated in the head, accounting for 59.52%. Most of injuries were mild and moderate, accounting for 72.26% and 27.60%, respectively. Conclusions Schools are the main location for physical assault injuries among students, with boys and middle school students being the most vulnerable populations. Targeted intervention measures should be implemented to effectively reduce the occurrence of physical assault injuries among students.

Vaccination certificate verification for children enrolled in kindergarten and primary school in Guizhou Province from 2020 to 2022

QIAO Sha, TANG Ning, DU Wen, DAI Lifang, DING Ling

2024, 45(4): 589-592. doi: 10.16835/j.cnki.1000-9817.2024110

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Objective To evaluate the implementation of vaccination certificate verification in Guizhou Province from 2020 to 2022, so as to provide reference for improving the efficiency of vaccination certificate verification and vaccine re inoculation work. Methods Data was drawn from the 2020-2022 report on the verification of vaccination certificates for children entering daycare and enrollment in various cities and prefectures in Guizhou Province. In July, 2021, Guizhou Province began to implement a new inspection scheme with close cooperation between health and education departments, moving forward the gateway, parents using "Guizhou CDC" WeChat official account for self-inspection, and a long-term supervision and assessment mechanism. A comparative analysis was conducted on the evaluation of vaccination certificate verification rate, vaccination certificate holding rate, full revaccination rate of the National Immunization Program (NIP) for children and full vaccination rate of the NIP vaccine before(2020) and after(2021 and 2022) the implementation of the new plan. Chi-square test was used for statistical analysis. Results The rate of vaccination certificate verification of children enrolled in kindergarten and primary school in Guizhou Province increased from 99.85% in 2020 to 100% in 2022, the rate of holding certificate increased from 99.55% in 2020 to 99.91% in 2022, the rate of full vaccination NIP vaccines for kindergarten and primary school entry increased from 78.95% in 2020 to 96.59% in 2022, and the rate of full revaccination increased from 42.40% in 2020 to 79.19% in 2022 (χ²=2 203.19, 3 651.67, 291 896.31, 103 938.76, P < 0.01). Conclusions From 2020 to 2022, the rates of full vaccination and the full revaccination for NIP vaccine among children entering kindergarten in Guizhou Province have increased year by year. Each region should fully utilize the achievements of immunization planning informatization construction to establish effective inspection work ideas, and ensure that eligible children complete the full vaccination process of the national immunization plan vaccine.

Syndromic surveillance, early warning and management of mycoplasma pneumoniae pneumonia in school

QIN Ran, GUO Xin

2024, 45(4): 593-594. doi: 10.16835/j.cnki.1000-9817.2024040

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Abstract:
Mycoplasma pneumoniae pneumonia (MPP) refers to pulmonary inflammation caused by mycoplasma pneumoniae (MP) infection, commonly seen in children aged 5 and above, with fever and cough as the main clinical symptoms. As the primary transmission is through direct contact and respiratory droplets, MPP is prone to cause cross-infections in schools and homes. To improve school-based prevention and control of MPP, the article proposes comprehensive and multi-link technical requirements for the organization and management system of MPP syndromic surveillance and early warning, monitoring contents and methods, information report and disposal. A set of MPP syndromic surveillance, early warning and management plans in school is formulated to strictly prevent and control clustered epidemics on campus.

Progress of research on brain breaks in cultural classrooms to promote students' physical activity levels

JIANG Jiajun, YIN Mingyue, LIU Haohui, SONG Jian, NIU Xiao, YIN Zhihua

2024, 45(4): 595-598. doi: 10.16835/j.cnki.1000-9817.2024123

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Abstract:
Brain Breaks is a physical activity program that combines cultural classroom-based physical activity with modern technology while providing children with multi-level guidance. As an intervention for intermittent sedentary activities, Brain Breaks can improve students' physical activity level, thereby improving their physical fitness and positively affecting their motivation to participate in physical activities and positive learning behaviors. The paper understands this intervention from the connotation, implementation basis, and application effect of Brain Breaks, and then proposes practical application suggestions and future research directions.When Brain Breaks in the cultural classroom is promoted and practiced in China in the future, attention should be paid to the means of implementation by the teachers, the selection of representative target groups, and the precise implementation plan.At the research level, the effects of motor skills, special group interventions, gender differences, environmental changes, and physiological mechanisms of the Brain Breaks are to be explored.

Research progress on the association between biorhythm disorders and cardiovascular metabolic risk in adolescents and possible mechanisms

HAN Feifei, XIE Yang, TAO Fangbiao

2024, 45(4): 599-603. doi: 10.16835/j.cnki.1000-9817.2024130

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Abstract:
Adolescence is a unique transitional period from childhood to adulthood, during which behavioral habits and physiological cycles undergo significant changes, and biorhythms are vulnerable to be disrupted. Meanwhile, due to increased rates of overweight and obesity, cardiovascular metabolic risk significantly increases during adolescence. The article reviews the prevalence, correlation, and potential epigenetic regulatory mechanisms of biorhythm disorders and adolescent cardiovascular metabolic health, providing a theoretical basis for regulating biorhythm to promote adolescent cardiovascular metabolic health.

Research progress on the characteristics of head injury in children and adolescents

HUANG Da, LUO Weidong, XU Zhen, XIAO Li

2024, 45(4): 604-608. doi: 10.16835/j.cnki.1000-9817.2024111

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Abstract:
The harm of head injury in skateboarding is more serious. The common injury cause is fall, collision, high-speed impact. The primary types of injury include skull fracture, subdural hemorrhage, brain laceration contusion and concussion. Older children and adolescents, males, longboard, inappropriate sports venue are important risk factors for severe traumatic brain injury. Designing special skateboard parks and wearing protective equipment (helmets) can effectively reduce the incidence and severity of head injuries. The occurrence of injury can be reduced by adopting both legislation and education measures.

Current Articles 2024, Volume 45, Issue 4

Current Articles
2024, Volume 45, Issue 4